This document provides a proforma or application form for an unspecified job posting. It requests information such as name, address, date of birth, retirement date, educational qualifications, employment history, salary details, and references. It also asks if the applicant belongs to any reserved categories and requests copies of performance evaluations from the last 5 years. The final date to submit the completed application is listed as February 9, 2015.
This document provides a proforma or application form for an unspecified job posting. It requests information such as name, address, date of birth, retirement date, educational qualifications, employment history, salary details, and references. It also asks if the applicant belongs to any reserved categories and requests copies of performance evaluations from the last 5 years. The final date to submit the completed application is listed as February 9, 2015.
This document provides a proforma or application form for an unspecified job posting. It requests information such as name, address, date of birth, retirement date, educational qualifications, employment history, salary details, and references. It also asks if the applicant belongs to any reserved categories and requests copies of performance evaluations from the last 5 years. The final date to submit the completed application is listed as February 9, 2015.
This document provides a proforma or application form for an unspecified job posting. It requests information such as name, address, date of birth, retirement date, educational qualifications, employment history, salary details, and references. It also asks if the applicant belongs to any reserved categories and requests copies of performance evaluations from the last 5 years. The final date to submit the completed application is listed as February 9, 2015.
2. Date of Birth: 3. Date of retirement under Central / State Govt. Rules: 4. Educational Qualifications: a. Whether educational & other qualifications required for the post as per the notification are satisfied (if any qualification has been treated as equivalent to the one prescribed in the rules, state the authority for the same)
Essential: Sl. No. 1.
State Qualifications / Experience
required as per notification
State Qualifications / Experience
possessed by the officer
2. 3. 4. 5.
5. Please state clearly whether in the light of the entries made by you above, you meet the requirements of the post or not:
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6. Details of employment in chronological order. Enclose a separate sheet, duly
authenticated with your signature, if the space below is insufficient: Sl. No.
Office/Institution/ Organization
Post held
From
To
Scale of pay and Basic Pay therein
Nature of Duties performed
1. 2. 3. 4. 5. 7. Nature of present employment i.e., ad-hoc or temporary or quasi-permanent or permanent:
8. In case present employment is held on deputation / contract basis, please state:
a) The date of initial appointment: b) Period of appointment on deputation / contract: c) Name of the parent Office / Organization to which you belong: 9. Please state whether working under: a) b) c) d) e) f)
Central Government State Government Universities Autonomous or Statutory Organizations Recognized Research Institutions Private Organizations
10. Are you in a revised scale of pay? If yes, give the date from which the revision took place and also indicate the pre-revised scale:
11. Total emoluments drawn per month with break up or Basic Pay, GP, DA etc. 12. Additional information, if any, which you would like to mention in support of your suitability for the post. Enclose a separate sheet, duly authenticated with your signature, if the space below is insufficient:
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13. Whether belongs to SC/ST/OBC:
14. Whether belongs to PH Orthopedically Handicapped:
(Certificate to be enclosed)
15. Copies of Annual Confidential Reports (ACRs) for the last 5 years:
16. Name & Addresses of two references
17. Any other information not covered in the above columns.
18. List of enclosures:
DD Particulars Certificate Certified that the information furnished above is true and correct to the best of my knowledge and belief. If any information is found to be willfully suppressed or found not correct, I will forego my employment and abide by any disciplinary action by the Competent Authority.
Date: Signature of the Candidate Address Certificate (to be issued by the forwarding Authority) It is certified that the particulars furnished above are correct and no disciplinary case is either pending or contemplated against the officer and no penalty, major or minor, was imposed on the officer during the last 10 years and his integrity is beyond doubt. Signature of the Head of Department with (Stamp) Page 3 of 3
